Parts C & D Enrollee Grievances, Organization/Coverage Determinations, and Appeals Guidance
Guidance for the provisions set forth at 42 CFR Part 422 Subpart M and 42 CFR Part 423 Subparts M and U that addresses grievances, coverage/organization determinations, and appeals for beneficiaries enrolled in a plan provided by a Medicare Advantage (MA) organization, a Medicare cost plan, health care prepayment plan (HCPP), or a stand-alone Part D plan.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: January 01, 2020
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.